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Leptin and adiponectin during the first week after kidney transplantation: biomarkers of graft dysfunction?
- Source :
- Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP
- Publication Year :
- 2015
-
Abstract
- Context and Objective Based on evidence that leptin and adiponectin are removed from circulation primarily by the kidney, we designed a study to examine the longitudinal changes of these adipokines during the first week after kidney transplantation (KTx) and to test the hypothesis that higher levels of leptin and/or adiponectin could be early biomarkers of delayed graft function (DGF = dialysis requirement during the first post-transplant week) and acute rejection. Study Design Repeated-measures prospective study. Material and Methods Forty consecutive adult patients with end-stage renal disease who were undergoing KTx. Leptin and adiponectin were measured in blood samples that were collected before (day-0) and after KTx (days-1, 2, 4 and 7). Linear mixed-models, receiver operating characteristic and area under curve (AUC-ROC) were used. Results At post-transplant day-1, leptinemia and adiponectinemia declined 43% and 47%, respectively. At all times studied after KTx, the median leptin levels were significantly higher in patients developing DGF (n = 18), but not adiponectin levels. Shortly after KTx (day-1), leptin values were significantly higher in DGF recipients in contrast to patients with promptly functioning kidneys, approximately two times higher when controlling for gender and BMI. The leptin reduction rate between pre-tranplant and one-day after KTx moderately predicted DGF (AUC = 0.73). On day-1, serum leptin predicted DGF (AUC-ROC = 0.76) with a performance slightly better than serum creatinine (AUC-ROC = 0.72), even after correcting for BMI (AUC-ROC = 0.73). Separating this analysis by gender showed that the performance of leptin in predicting DGF for male gender (AUC-ROC = 0.86) improved. Conclusions Kidney graft function is an independent determinant of leptin levels, but not of adiponectin. Leptin levels at day-1 slightly outperformed serum creatinine in predicting the occurrence of DGF, and more accurately in male gender. No significant association was detected with acute rejection.
- Subjects :
- Adult
Male
Leptin
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Adipokine
Delayed Graft Function
Context (language use)
Kidney
Sensitivity and Specificity
Cohort Studies
Kidney transplantation
chemistry.chemical_compound
Endocrinology
Hospitals, Urban
Internal medicine
medicine
Humans
Postoperative Period
Prospective Studies
Prospective cohort study
Creatinine
Adiponectin
Portugal
business.industry
medicine.disease
Kidney Transplantation
Up-Regulation
medicine.anatomical_structure
Early Diagnosis
chemistry
Kidney Failure, Chronic
Female
business
Biomarkers
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP
- Accession number :
- edsair.doi.dedup.....16584fdf9b336501fa561a0df0672727